Closed chest drainage

1
Closed chest drainage
2
Case Study

• Mr. E, a 62 year-old white male, was rabbit
  hunting when his gun accidently discharged. He
  has a thoracic entry wound and is experiencing
  increased respiratory difficulties. He is
  brought to the Emergency Department, and on
  evaluation is found to be tacypneic, cyanotic,
  with breath sounds diminished in the left upper
  lung and absent at the left base.
• What is Mr. Es presenting problem?
• What does the physician determine Mr. E needs?

3
Water Seal Drainage

• What is the basic principle of water seal chest
  drainage?
• What are three physiologic indications for chest
  tube insertion?
• Identify two evacuation forces which are used in
  water-seal chest drainage.

4
Describe the function of each chamber
5
Identify Nursing Observations Related to Each
Chamber
6
Patient Assessment

• What nursing assessments should be made about the
  patient who has a water seal chest drainage
  system?

7
Complications

• Identify three problems which can occur in chest
  drainage systems.
• What can be done to correct these problems?

8
Nursing Diagnoses

• What nursing diagnoses would be appropriate for
  this patient?

9
QA

• The water seal in a disposable chest drainage
  system is effective if the water seal chamber is
  filled to the level of
• A. 0.5 cm H2O
• B. 1.0 cm H2O
• C. 1.5 cm H2O
• D. 2.0 cm H2O
• During the first 24 hours, drainage should be
  documented? _______________.
• A water seal chamber that bubbles continuously
  indicates _____________________.

10
Chest Tube Removal

• What are nursing responsibilities associated with
  the removal of a chest tube?